Ungava coast women giving birth closer to home

This birthing room at Tulattavik’s health centre is where more than 60 new babies have come into the world this year. Once a woman delivers, she remains under a midwife’s care for 24 hours and, if all is well, she can fly home in three days. (PHOTO BY SARAH ROGERS)

As the patient transit centre at Kuujjuaq’s Tulattavik health centre is being renovated and expanded, the current facility (at right) will be converted into a new birthing centre, equipped with more private rooms and a birthing tub. (PHOTO BY SARAH ROGERS)

KUUJJUAQ — Outside the birthing room at Kuujjuaq’s Tulattavik health centre, a mural of footprints spreads gradually across the hallway.

Every time a baby is born at the hospital, its tiny footprint is captured in ink and posted alongside the baby’s name and date of birth, as a way of introducing the new life to the world.

These images are a reminder of a growing trend: more and more pregnant women who live in the seven communities along Nunavik’s Ungava coast are delivering their babies in Kuujjuaq, with the help of midwives at Tulattavik’s birthing centre.

Midwifery started in Kuujjuaq in 2009, with only a third of pregnant women along the Ungava Bay coast opting to give birth there.

In 2010, 37 women gave birth in Kuujjuaq.

But, by the beginning of last month, the birthing centre had already registered 62 births in 2011.

That’s a huge increase from 2011, when midwives delivered about five babies a month.

“Now, it’s closer to 10 — we’ve almost doubled our deliveries,” said Nadia Balla, midwife and co-ordinator of Tulattavik’s birthing program. “We expect to have about 90 births here in 2011.”

Balla, who arrived in Kuujjuaq in February, 2010, reports a good response from both new and repeat mothers about the midwifery program.

Tulattavik’s expanding midwifery program resulted from due to a policy change made in September, 2010.

In December the hospital’s board of directors finally decided to stop paying transportation and housing bills for pregnant women who wanted to deliver in Montreal and for their escorts, unless there were medical reasons for them to travel south. Under the new policy, the health board won’t even pay for escorts of pregnant women travelling to Kuujjuaq to deliver.

“There are some who still decide to go to Montreal, but it doesn’t happen often,” Balla said. “Ironically, those who must be sent to Montreal for medical reasons don’t want to go.”

In addition to the cost benefits of keeping Ungava coast women closer to home, midwife-led births correspond well to Inuit women’s quick deliveries, Balla said, as she displays charts of patients’ labour times which vary between two and five hours.

Balla also calls the experience of delivering with a midwife “empowering” for women.

“We don’t often hear about fear of pain of childbirth, but it happens,” she said. “We provide a lot of support to cope with pain, like the exercise ball and back massages. And there’s a lot to say about birth preparation.”

Balla and her co-worker midwife Johanne Pépin have just begun offering prenatal courses to expecting couples.

That’s not the only addition to Tulattavik’s midwifery program. As the hospital’s patient transit centre is being renovated and expanded, its current facility will be converted into a separate birthing centre, equipped with more private rooms and a birthing tub.

The expansion will provide an important boost to the growing program, Balla said, adding that there is still room to grow.

Balla hears from Inuit women that they’d like to see Inuit midwives, or even study midwifery themselves.

But until Kuujjuaq’s program brings in more midwives, the hospital’s two midwives just don’t have the time and resources to take on students.

“It’s a really big undertaking,” Balla said.

The Ungava coast faces the same challenges with expanding its midwifery program to other communities.

Even in Kangiqsualujjuaq, where nine local women have delivered at Tulattavik this past year, the number of births is still not high enough to justify the hiring of a local midwife, Balla said.

At 37 weeks, pregnant women who live outside Kuujjuaq come to town where a midwife sees them every week until they deliver.

Once a woman delivers, she remains under a midwife’s care for 24 hours and, if all is well, she can fly home in three days.

Kuujjuaq’s program is modelled after the Inuulitsivik health centre’s midwifery program along Nunavik’s Hudson Bay coast, where midwives in three maternity centres in Puvirnituq, Inukjuak and Salluit have been delivering babies since 1986.

According to Quebec’s order of midwives, 85 per cent of pregnant women who live there can now give birth in or near their home communities.